Abstract
Pott's disease is a known disorder that affects the spine causing various degree of disability for the patients that ranges from mild to severe kyphosis with or without neurological deficits. In most cases single level is affected and in fewer numbers two levels are affected. Rarely more than two levels are affected. In this case we present a case of Pott's disease affecting five adjacent segments with vertebral sequestration. This is 43 years old female patient presented to Assuit university hospital with history of repeated attacks of back pain and mild fever since 4 years the patient received empirical antibiotic after which she said that she partially improved and after then the patient became accustomed to repeat the antibiotic with no medical consultation. Later on the pain became sever but no neurological manifestations then she had X-ray and MRI with diagnosis of long segment vertebral osteomyelitis affecting T7-T12. Posterior costotransversectomy approach was done and the sequestrated vertebral bodies and intervening discs were excised and sent for culture sensitivity and biopsy and mesh cage was applied to bridge the defect and pedicle screws are inserted from T5 to L2, and later on antituberculous regimen was started after the diagnosis was established. Postoperatively the neurological status was intact and the pain improved; 6 month follow up showed good bone healing. Stable cage and pedicle screws and much improvement in the general status of the patient.